Part I. General Information

(Please print or type)
 
 
 
 

1. Name in full _____________________________________________________________________________

Social Security Number ________________________________ Home Phone _____________________

2. Home Address ___________________________________________________________________________

____________________________________________________________________________________

3. School Address ___________________________________________________________________________

____________________________________________________________________________________

Zip ______________________ School Phone ___________________________________

4. Name of high school ______________________________________________________________________

5. Name of college or university for 2002-2003 school year ______________________________________

6. Intended program of study or major ________________________________________________________

8. What will your class level be in 2002-2003? freshman ___ sophomore ___ junior ___ senior ____

9.  If you answered no to question 7, have you been accepted by this educational institution for the fall
2002 term? Yes ______ No ______

10. Please give the name, address, and phone number for the financial aid officer of the educational institution you will be attending.

Part II. Church Service
 
 

1. In what church do you hold membership? __________________________________________________

2. When did you become a member? __________________________________________________________

3. Please list church activities you have participated in.
 
 
 
 
 
 

4. Share with us significant steps of Christian growth that you have experienced.
 
 
 
 
 
 
 
 
 
 
 

5a. Do you attend church services and/or activities on a regular basis? ______Yes ______No
Please explain:

6.  Do you you have plans for a future Christian vocation?  If so, tell us about them.
 
 
 

  Part III. Scholarship

(For all items a-f give information on current school -- high school or college)
 
 

1. School Name _______________________________________________________________________

b. GPA _________ 4 point system ______ 5 point system ______

c. Clubs and organizations:
 
 
 
 

d. Offices held:
 
 
 

e. Athletics:
 
 
 

f. Additional comments:
 
 

*List any factors that you feel should be taken into account by the committee reviewing this request, financial or otherwise.
 
 
 
 
 
 
 
 
 
 
 
 
 
 

I HEREBY CERTIFY that I have read and understand the guidelines for making scholarship grants; that to the best of my knowledge the above information is true and accurate. I also authorize the release of this information to any other members of the Committee on Scholarships.
 
 

Signed ___________________________________________________ Date _______________
 
 
 
 

After completing your part, give the application to your session for their enclosement.  The session must mail the entire completed form to Presbytery office by June 1.  An "Endorsement of Session" form must be submitted to Presbytery's office every time you apply for a scholarship grant.
 
 

Note to the Session:
 
 

When completing this endorsement, please specifically highlight the student's involvement in the church. Feel free to add information you feel is relevant to the student's application.
 
 

We, the Session of the ________________________________________________________ Presbyterian Church, in the Presbytery of Shenandoah, have personal knowledge of the applicant whose name appears above, and who has been a member of this church for ____________ years.
 
 

We believe the applicant should receive scholarship aid in light of the following information:
 
 
 
 
 
 
 
 
 
 
 
 

Adopted in meeting of session, this ___________ day of _____________________, year__________.

Signed:

_____________________________________________________Moderator

_____________________________________________________Clerk

THIS FORM IS CONSIDERED TO BE CONFIDENTIAL AFTER IT HAS BEEN COMPLETED.

It is the session's responsibility to send the completed application to the Presbytery office by June 1.